FALL 2009

Global Styles

PHOTO JESSE CANTLEY

Meg Styles ’08 combats international nurse shortage one country at a time

BY MONIQUE BEELER

Great personal loss often leads to great personal reinvention.

Meg Styles ’08 underwent a professional and personal transformation following the death of her beloved mother, global nursing pioneer Margretta “Gretta” Madden Styles, in 2006. Known as the “mother of nurse credentialing,” Madden Styles’ birthday, March 19, is honored nationally as Certified Nursing Day.

“I’m not a nurse myself,” says Styles, who earned her master’s degree in public administration from CSUEB. “(But) it’s in my DNA. I agree with my mother that nurses (serve in) the most noble profession.”

Holding no medical credentials of her own has not deterred Styles’ determination to put a dent in the global nursing shortage, estimated to be 4.3 million by the World Health Organization. In tribute to her mother’s life work, in 2007 she gave up her job in real estate and created the Gretta Foundation. The foundation’s mission is to provide scholarships to nursing students in the developing world, beginning in sub-Saharan Africa — which shoulders 24 percent of the global disease burden but has only 3 percent of the world’s health care workforce. In Malawi and Uganda, where the Gretta Foundation has a presence, rates of HIV/AIDS and tuberculosis infection and child and maternal mortality are disproportionately high.

“If you look at maternal health, these are terrifying numbers,” Styles explains. “The odds of dying in childbirth is 1 in 16 in developing countries. In the developed world, it’s 1 in 2,800. You see this play out on hospital clinic floors.”

At one Uganda hospital Styles visited, for instance, staff members grimly refer to the maternity ward as “The Factory.”

“You will step over woman after woman after woman on the hospital floor in active labor with virtually no assistance,” Styles says. “There are three or four nurses running around handling a workload beyond human capacity.”

In the United States, there are slightly fewer than 10 nurses for every 1,000 people in the population. By comparison, countries such as Uganda have fewer than one nurse per 1,000. “Whatever nursing shortages we have here, it’s nothing” compared with those in developing nations, she says. “Our focus is to (train nurses) in disease-burdened countries.”

The Gretta Foundation, Styles says, is the first nonprofit organization to award nursing scholarships to residents of impoverished nations who study and practice in their native country. For the price of one airline ticket to a U.S. university, the Gretta Foundation can cover expenses for two years of nursing education at an African institution. As part of their studies, Gretta Scholars also immediately gain experience providing health care in their communities. Once the program becomes established in a handful of African states, Styles plans to migrate the model to other developing nations.

Her parents surely would approve of her humanitarian mission and leadership.

A revered leader in nurse education, regulation, and credentialing, Madden Styles served as dean of nursing for the University of California, San Francisco for 10 years and held the presidency of the American Nurses Association, the International Council of Nurses, the California Board of Registered Nursing and the American Nurses Credentialing Center. Styles’ late father, the Rev. Douglas F. Styles, also pursued a noble public service profession, working as an Episcopal priest. Until recently, however, Styles had never experienced the kind of job satisfaction her parents enjoyed.

While Styles briefly explored a nursing career of her own with an emphasis on midwifery, the demanding UCSF program she considered had a 60-hour weekly schedule that became untenable when a divorce in her 20s left her raising her son and daughter on her own. To support her family, she worked for 13 years in commercial real estate.

“It was never very rewarding,” says Styles, who at 41 presents a dignified figure with a direct blue-eyed gaze and unwavering resolve. “My parents’ careers were a calling. I remember really being in awe of their passion and commitment.”

By the time she became ill with cancer, Madden Styles was in a position to leave an inheritance to her daughter that she hoped could give her the financial freedom to discover a calling of her own.

“My mother told me: ‘It gives me great peace to know that my passing will let you find out what you’re passionate about,’” Styles says. “So I went to Cal State East Bay and went to work for a nonprofit.”

“(CSUEB) was readily accessible — it’s nearby and they offer night classes,” Styles says. “I work with Ph.D.s, I’m a foundation director. Having the higher education credentials is important.”

While looking for a cause to devote her energy to while completing her master’s degree, Styles naturally gravitated toward a group with a health care imperative. For two years, she worked with Larkspur-based Global AIDS Interfaith Alliance, or GAIA, which provides HIV-related and basic health services in rural Malawi, a landlocked nation in southeast Africa about the size of Pennsylvania.

“They have wonderful programs — microfinancing, village health care, orphan care, and one program they had was nursing scholarships,” Styles explains. “You could spend a lifetime (providing health services) in Malawi, unfortunately. Beautiful people, they call themselves the warm heart of Africa.”

Following her tenure with GAIA, Styles was ready to launch the Gretta Foundation, which has continued working with GAIA to assist nursing students in Malawi but ultimately will also provide nurse education scholarships in other countries.

“I see an opportunity to have a phenomenal impact in people’s lives,” Styles says. “I get enraged, because it makes no sense to me that this work isn’t being done.”

“Someone needs to be specifically focused on getting nurses on the ground,” she says. “The people we want to help are the people who are most in need, and we want to do this in such a way that people stay where the need is so great.”

The life experiences that led a Gretta Scholar named Agnes to the program are not atypical.

One of eight children from a nearly penniless Ugandan family, Agnes spent 18 hours each day, seven days per week, between working and commuting to her restaurant job. Earning the equivalent of $2 per day, and with no educational opportunities or savings to help improve her professional or financial lot, Agnes’ future appeared as bleak as the health statistics plaguing her impoverished homeland.

Agnes had demonstrated intelligence and a tenacious spirit in completing her education through high school — never a given for girls growing up in rural areas of sub-Saharan Africa where families often prioritize the education of sons.

An e-mail message Styles sent Agnes notifying her that she had been selected as the first Gretta Scholar profoundly touched both women.

“It was really the most wonderful experience,” says Styles, seated in her Danville home office surrounded by snapshots from a Malawi orphanage, a ceramic wall hanging depicting African village life, and giraffe carvings collected by her mother. “We literally in a day changed a life.”

To date, 10 lives have been changed directly by Styles and others working through the Gretta Foundation, including partners at carefully selected nursing colleges in Malawi and Uganda. The number of lives that will indirectly benefit is incalculable. Scholarship recipients agree to work in their home country for a period equivalent to the number of years their studies were funded by the Gretta Foundation. Styles hopes they’ll remain “in-country” indefinitely and resist the brain drain that has led other health care workers to emigrate to the U.S., Canada, and the United Kingdom for better pay and working conditions.

“Our wish is that these nurses stay in-country,” she says. “We (achieve) this through different means.”

The foundation’s strategy involves focusing on students from rural areas who will be less likely to immigrate; elevating the professionalstatus and pay of nurse educators, who currentlyreceive lower pay than nurses; and working closely with each country’s National Nurses’ Association, which advocates for sound health policies that also can improve nurses’ professional satisfaction.

As director of the Gretta Foundation, Styles is determined to employ the most cost-effective and culturally relevant solutions to boosting the number of nurses in developing countries. Guided by an active board of directors — including some of her mother’s global nursing colleagues — she’s taken a methodical, research-based approach to structuring the organization.

Although her personal background may bear little resemblance to those of the rural Africans chosen as Gretta Scholars, Styles expresses great empathy and admiration for those the foundation seeks to help.

“If you look at the girls we’re offering scholarships to, (they live in) societies where girls are the last to be educated,” she says. “Imagine being a girl who’s already lost the opportunity to go to school or married very young. How do they ever have the vision that something else is out there for them?”

As a single parent working for years at a job she didn’t love, Styles once suffered from a similar lack of vision. Today, she sees clearly, knows what to do and where she’s headed. Previous personal hardships, professional disappointments, and the deaths of her parents, she says, contributed to shaping her newfound vision.

“All of it has brought me here, every single thing,” says Styles, as she prepares to rush off to a civic club meeting where she’ll spread the word about the Gretta Foundation, a seemingly non-stop activity for the organization founder. “I’m grateful, because I found something I’m passionate about. It doesn’t feel like work. The most satisfying thing is knowing we can do this in the thousands.

“Our work is to make a real impact where the need is so desperate,” she says. “I feel the Gretta Foundation — besides my children — is what I was born to do.”